Limitations
The following limitations apply to Recreational Therapy services:
One hour of billed therapy service must include a minimum of 45 minutes of direct
patient care with the balance of the hour spent in related patient services.
Activities not allowed
The following activities are not allowed as part of Recreational Therapy services:
- Payment for the cost of the recreational activities, registrations, memberships, or
admission fees associated with the activities being planned, organized, or directed - Any services that are reimbursable through the Medicaid State Plan
- Therapy services furnished to the participant within the educational/school setting or as
a component of the participant’s school day. - Group sizes greater than four participants to one Recreational Therapist or group sizes
exceeding the maximum allowable group size determined by the IST (Individualized
Support Team) for each group participant - Group services when group settings were not determined to be appropriate by the IST
(Individualized Support Team) for each group participant
